I am due to see a 13 year old boy who has been suffering from knee pain whilst swimming (he swims competitively) for around 4 - 6 months. He has been attending a sports physio who has advised that he is having growing pains, the physio is seeing him regularly. He has had X ray to both knees and hips which have been clear (no issues noted).
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The boy toes in on the right foot (and his mum advises that this has been the case as long as she can remember). The physio has advised the patient (and his mum) that he should see a Podiatrist to have a casted custom made orthotic (but to avoid off the shelf orthoses). I have spoken to the mum on the phone and she has confirmed that he has no pain at all when walking only when swimming.
I have explained that I am not in a position to cast and make an orthotic device but the patients mother is nervous about paying to have an orthotic made anyway if there is no guarantee that this will solve the problem whilst swimming (the main issue).
Has anyone experienced issues like this before (i.e. recommending an orthotic when there is no pain or discomfort during gait). What advice can you give around orthoses for toe in at that age (I was thinking that it would possibly correct itself over time as part of the growth of the limbs?). I appreciated that it would possibly be best to do my full assessment then ask for advice, however it would be great if you could give me some guidance in advance. I am just a bit perplexed as to the benefit of an orthosis for issues that occur outwith gait. Any help would be appreciated.
Thanks
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Dorsal interosseous compression syndrome after heel lift
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Does the tibia drive the foot or does the foot drive the tibia?
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Dorsal interosseous compression syndrome after heel lift
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Does the tibia drive the foot or does the foot drive the tibia?
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